Sample Pre-test

Attachment F1 Sample Pre-Test.doc

Information Collection for Evaluation of Education, Communication, and Training Activities for Mobile Populations

Sample Pre-test

OMB: 0920-0932

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Customs and Border Protection Basic Training Evaluation


Pre-evaluation

I.D. Number____________ Class_________________

Date _________________



The purpose of this pre-evaluation is to measure baseline knowledge of public health issues as they relate CBP officers’ jobs. You will be asked questions related to the public health training you will receive today. Your individual responses will not affect your advancement through basic training.

To help us measure the training’s impact on your public health knowledge gained, a unique I.D. number will be assigned to you. This number consists of the two digits of your birth month, the two digits of your birthday, and the first two letters of your last name. (For example, the I.D. number of a person born on April 12 whose last name is Lewis would be 0412LE). Please write your I.D. number clearly on the line provided at the top left corner of this page. You will need to use the same I.D. number for future evaluations of your public health training.

Please circle the letter of the best answer.

  1. After you recognize an ill traveler, what should you do next?


a) Contact your supervisor to alert the CDC quarantine station.

b) Separate the ill person 6 feet away from others.

c) Put on an N-95 respirator.

d) Pass out Travel Health Alert Notices to passengers nearby.


  1. Which method should you use to report an ill traveler to the Centers for Disease Control and Prevention (CDC)?

a) Contact the Quarantine Station closest to your port.

b) Contact CDC headquarters.

c) Contact the quarantine station whose jurisdiction includes your port of entry.

d) Contact the local health department to alert CDC.


  1. Which of the following animals or animal products are restricted for importation by the CDC?


a) Ball python

b) Lions and tigers

c) Civets, and Gambian rats and other African rodents

d) Turtles with shells greater than 4 inches in length


  1. Which of the following fits the definition of a reportable illness according to the Code of Federal Regulations (42 CFR 71)?


a) Fever and skin rash

b) Mild diarrhea

c) Headache and jaundice

d) Persistent sneezing


  1. A University of Glynco microbiology instructor is returning to the United States with infectious blood samples. Which of the following does he need to provide to legally import these samples?


a) Etiologic agent permit issued by CDC

b) Waiver for a Class A health condition

c) Travel Health Alert Notice (T-HAN)

d) International License for the Importation of Infectious Agents


  1. Which of the following questions would be appropriate to ask a traveler that you suspect may be ill?


a) Do you need any antibiotics?

b) Do you have a fever?

c) Would you like some aspirin?

d) Do you want me to take your temperature?


  1. Dogs arriving from countries that are not identified by CDC as rabies-free must meet which of the following criteria:


a) Proof of rabies vaccination given at 3 months or older

b) Proof of rabies vaccination given at least 30 days before entry

c) Neither A or B

d) Both A and B


  1. For which of the following situations should you alert your supervisor and the CDC Quarantine Station?


a) A traveler with a sore throat

b) A properly packaged container of blood samples with an etiologic agent permit

from CDC

c) A traveler with a pet turtle

d) An immigrant who has TB class B1 (active, noninfectious TB)


  1. The acronym RING describes concise instructions for identifying and responding to public health threats. What does RING stand for?


a) Respond, Identify, Notify, Get help

b) Recognize, Identify, Notify, Give Support

c) Recognize, Isolate, Notify, Give Support

d) Rescue, Isolate, N-95, Give first aid


  1. Which three sections do you need to review on the Immigrant or Refugee medical exam (DS 2053 or DS 2054)?


a) Class A conditions, Class B conditions and expiration date

b) Class A conditions, Class B conditions and laboratory findings

c) Class A conditions, Class B conditions and Class C conditions

d) Class B conditions, HIV Test Results, TB Test Results


  1. Do you have previous experience doing health-related work?


a) Yes

b) No


If yes, what type of health-related work and for how long? ____________________

__________________________________________________________________



  1. As a CBP officer, what would you like to learn from this public health training?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


Thank you for your participation!

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File Typeapplication/msword
File TitlePRE-EVALUATION
Authorhsy2
Last Modified BySYSTEM
File Modified2018-03-21
File Created2018-03-21

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